Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India.
Department of Microbiology, AIIMS, New Delhi, India.
Indian J Tuberc. 2022 Jan;69(1):48-57. doi: 10.1016/j.ijtb.2021.02.010. Epub 2021 Mar 9.
To evaluate the hysteroscopic findings in female genital tuberculosis.
It was a prospective study of hysteroscopic findings performed on 348 cases of female genital tuberculosis (FGTB).
It was a prospective cross-sectional study in a tertiary referral centre.
A total of 348 patients with infertility with FGTB on various tests.
A total of 348 patients of infertility found to have FGTB on various investigations were enrolled in the study. A detailed history was taken. Clinical examination, endometrial sampling and diagnostic laparoscopy were performed was also performed in selected cases. All patients underwent hysteroscopy as part of evaluation for infertility and tuberculosis (TB) findings.
The mean age, parity, body mass index and duration of infertility was 28.2 years, 0.31,23.1kg/m and 3.44 years respectively. Infertility was primary in 81.03% and secondary in 18.96% cases. Diagnosis of FGTB was made by endometrial aspirate findings of positive AFB on microscopy (4.02%), positive culture (4.88%), positive PCR (83.90%), epithelioid granuloma (14.65%), positive AFB on microscopy or culture of peritoneal cytology (1.14%) or epithelioid granuloma on peritoneal biopsy (1.72%), definitive findings of TB on laparoscopy (41.95%) or probable findings of TB on laparoscopy (58.05%). Various hysteroscopic findings observed were normal findings (28.16%), pale endometrial cavity (54.31%), features of active TB (7.47%), features of chronic TB (19.54%), features of TB sequelae like obstructed ostia (both ostia in 13.79%, one ostia 14.94%, periostial fibrosis; (bilateral 4.59%, unilateral 5.17%), endometrial glands atrophy (12.35%), small shrunken cavity (6.32%), distorted cavity (5.17%), various grades of intrauterine adhesions (29.88%). Hysteroscopy in FGTB was associated with increased difficulties and complications like failed procedures, difficult visualisation, false passage and uterine perforation.
Hysteroscopy is useful modality to detect endometrial TB but is associated with increased difficulty and complications.
评估女性生殖器结核的宫腔镜表现。
这是一项对 348 例女性生殖器结核（FGTB）患者进行宫腔镜检查的前瞻性研究。
这是一项在三级转诊中心进行的前瞻性横断面研究。
共有 348 例因不孕症在各种检查中发现 FGTB 的患者。
对各种检查发现 FGTB 的 348 例不孕症患者进行了研究。详细询问病史。对部分患者进行了临床检查、子宫内膜取样和诊断性腹腔镜检查。所有患者均接受宫腔镜检查，作为不孕症和结核病（TB）检查的一部分。
平均年龄、产次、体重指数和不孕持续时间分别为 28.2 岁、0.31、23.1kg/m 和 3.44 年。原发性不孕症占 81.03%，继发性不孕症占 18.96%。FGTB 的诊断是通过子宫内膜抽吸物显微镜下发现抗酸杆菌阳性（4.02%）、培养阳性（4.88%）、PCR 阳性（83.90%）、上皮样肉芽肿（14.65%）、腹腔细胞学抗酸杆菌阳性或培养阳性（1.14%）或腹腔活检上皮样肉芽肿（1.72%）、腹腔镜下明确的 TB 发现（41.95%）或腹腔镜下可能的 TB 发现（58.05%）。观察到的各种宫腔镜表现为正常表现（28.16%）、苍白的子宫内膜腔（54.31%）、活动性 TB 特征（7.47%）、慢性 TB 特征（19.54%）、TB 后遗症特征如阻塞的宫口（双侧 13.79%，单侧 14.94%，骨膜纤维化；双侧 4.59%，单侧 5.17%）、子宫内膜腺体萎缩（12.35%）、小的缩小腔（6.32%）、变形腔（5.17%）、各种程度的宫腔粘连（29.88%）。FGTB 中的宫腔镜检查与增加的困难和并发症相关，如手术失败、可视化困难、假道和子宫穿孔。
宫腔镜检查是检测子宫内膜结核的有用方法，但与增加的难度和并发症相关。
